While there are numerous causes of back pain, sleeping on an old, worn-out mattress can certainly be one of them.

Here are a list of signs that your mattress may be causing or contributing to your back pain and consequently, decreasing the quality of your sleep:

You wake up frequently during the night with no explanation.

You consistently shift sleeping positions because you can’t get comfortable.

Pressure points, like your shoulders and hips, feel uncomfortable in a side sleeping position.

You use a pillow under or between your knees to try to get relief from the discomfort.

You feel pushed to the center of your bed by a sagging, unsupportive mattress.

You wake up with back pain, but it decreases after 20-30 minutes.

Ultimately, mattresses should be replaced every 8-10 years to maintain a clean, supportive sleeping surface. It’s gross, but more sweat, dead skin, and dust mites accumulate over time than you’d like to believe.

If you’re suffering from back pain, take note of the list above to evaluate whether your mattress could be worsening the problem.